A Simple Checklist Can Make You More Effective Than You Ever Imagined

After all, it saved 8 lives plus $2M.

Atul Gawande, a surgeon at John Hopkins Hospital stumbled upon a stupidly simple tactic to improve the efficiency of doctors in detecting infections. The tool ended up saving eight lives, detecting forty-three extra infections, and to top it off, saved two million dollars. All this over a span of a year.

The tool I’m talking about is neither a silicon-valley bio-tech invention nor a piece of complex machinery that only doctors can read.

In fact, it’s so simple that a five-year-old can use it. What is it?

drumroll please

A checklist.

Bummed, are ya?

I know it’s hard for you to believe how a simple checklist can save lives and millions of dollars.

But their strategy was mind-blowingly simple. Peter Pronovost, a critical care specialist, made a 5-step checklist with “stupidly simple” steps like washing hands before the operation and so on.

When followed, this simple checklist saved millions of dollars in a high-stake situation.

In the 20th century, hospital systems were not as complex as they were today. If you went to a hospital, you’d be lucky to find a few beds and nurses to take care of you. From personal experience, I’ve seen hospitals become bigger and harder to operate in the last fifteen years itself.

But this growth comes with a cost. Even though we have world-class equipment and believe modern medicine can make us live forever, the doctors have a harder time using these tools.

To add on, as jobs have become more specialized, you find roles in hospitals that you’ve neither heard of nor can explain what they do.

The consequences of ineffectiveness in medicine can be critical.

When doctors fail to diagnose an illness, for example, even by a small percentage, it can lead to catastrophic results — not just for the patient but everyone attached to them.

My father sought three different opinions about his health condition last year. He couldn’t sleep and had breathing problems. One doctor wanted to admit him right away. Dad refused.

Another one told him that it was kidney stones. Yet another one gave him some medicines and told to rest at home.

“What the hell is happening?” I used to think. Finally, we found he had a heart condition and had to see a cardiologist who admitted him for a week to run tests and fix the problem.

Heart conditions and kidney stones are not overwhelmingly complex. Then why did the three doctors have different diagnoses?

This underscores an important insight — complex professions like medicine should have standardized procedures for diagnosing the cause of illness.

Think about it. When it comes to your health, would you rather depend on a universally-adopted procedure for diagnosis or your doctor’s intuition?

That is what Gawande was able to achieve. A systematic checklist developed by a specialist which if followed, resulted in massive success.

How a Checklist Improved the Odds of the US Army’s Success in WWII

In his book, *The Checklist Manifesto *Gawande further gives an apt example of the power of checklists.

In the 1930s, U.S. Army Air Corps held a competition to choose a manufacturer for long-range bombers.

Amongst all aspiring manufacturers, Boeing’s plane could carry five times the bombs requested and flew faster than the other ones.

But when it came to its demonstration, the plain crashed followed by a fiery explosion. The Army concluded that the plane was too complex to fly and the pilots couldn’t possibly remember the steps needed to take-off.

Even though the Air Corps declined them, the military didn’t give up on Boeing — they wanted a faster and deadlier plane.

They were convinced that Boeing’s planes could work if the pilots flew the well. This time, they achieved this with — you guessed it — pre-flight checklists.

Something as simple as making a list of actions to perform before taking off was enough to turn a failure into a roaring success.

Flying bombers and medical professions are only one example. You see the power of checklists at play everywhere.

Checklists Free Up Mental RAM

David Allen in his productivity classic, [Getting Things Done](https://www.amzn.com/dp/0142000280), outlines the importance of making lists and writing things down.

The reason is simple — the brain is bad at holding things in memory.

Checklists free up mental RAM that you can apply to the task at hand instead of worrying about all the things you’ve to do next. And in a high-stress high-stakes situation like an operation theatre, it can be the difference between life and death.

Imagine this. I assign you as the head of fire emergency employee training.

Your task is to train everyone in a company how to escape in the event of a fire. If you’re a good trainer, you’ll give them a list of things to do. That could include points like:

  • Don’t use the elevator

  • Use the back exit

  • Assemble in the front lawn which is far from the building

The last thing you want them to do is to sit there thinking about the next steps while putting their lives in danger.

Checklists Enforce Discipline

They are also a great way to enforce discipline. By writing the things you have to do you ensure that you get them done. This is why pilots still go through a checklist, albeit verbally, whenever they take-off.

Part of it is the dopamine hit you get after checking items off a list. Everyone loves that feeling. This is why giving a checklist to people increases the chances of getting the task done.

Checklists Force You To Pay Attention to the Fundamentals

You saw what happens when we ignore the fundamentals because they’re not sexy.

Washing hands? Who wants to do that? (Side note: The pandemic has made us realize the importance of that though).

We forget that the fundamentals come first and the sexy stuff comes after. Checklists ensure that you do the minimum tasks that need to be done.

How to Use Checklists

Let’s explore a few ways I use checklists in my own life.

Blog posting checklist

  • Treat subheads like headlines

  • Edit for flow. Try using new, meaningful words when possible.

  • Run it through Hemingway

  • Add a CTA

  • Capitalize titles and subtitles

  • Use prevalent copywriting techniques wherever necessary

  • Use a headline analyzer

  • “Am I promising something in a headline and then delivering on it?”

  • Cross-linking posts if relevant

  • Add tags

Going-out checklist

  • Phone

  • Handkerchief

  • Wallet

  • Sanitizer (COVID)

  • Mask (COVID)

  • Laptop and charger

  • Mouse

  • Keyboard

  • Phone charger

  • Face wipes (I’m allergic to dust)

Morning Routine

I list the daily tasks I need to do every day:

  • Meditate (40 mins to 1 hour)

  • Exercise

  • Write

  • Reading and commenting on Medium posts

  • Posting and interacting with connections on LinkedIn

  • A quick glance at the stock market and financial news

  • Have breakfast

  • Meditate (10 mins)

I do (at least try) all this before 11 am which is when I have my first meeting.

Make Your Checklist Now

Think about an area of your life where you can free some mental space.

Tasks where you’d like to worry less about what to do instead of doing it.

You can make a checklist to go through before you submit your work to the team at your day job.

You can make a checklist to use when you pack for travel.

You can make a checklist for your wind-down routine.

There are hundreds of ways you can use them, and they never disappoint.

While you may not be in a position to save lives with them, you can still go very far with a simple checklist.

And when personal growth and productivity is so simple, why wouldn’t you give it a try?

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Written on October 3, 2020